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Inpatient follow-up in the palliative care center or the cardiology clinic in patients with end-stage heart failure? cost-effectiveness study, two-center retrospective study
Nuray Yılmaz Çakmak1, Gülay Aydın2, Kadriye Kahveci31İç Hastalıkları Kliniği, Palyatif Bakım Merkezi, Ankara Yıldırım Beyazıt Üniversitesi, Ankara Bilkent Şehir Hastanesi, Ankara, Türkiye2Kardiyoloji Kliniği, Darıca Farabi Eğitim Ve Araştırma Hastanesi, Kocaeli, Türkiye
3Yoğun Bakım Kliniği, Anestezi Ve Reanimasyon Anabilim Dalı Sağlık Bilimleri Üniversitesi, Ankara Bilkent Şehir Hastanesi, Ankara, Türkiye
INTRODUCTION: The aim of this study is to compare the treatment costs, hospitality costs and total costs of the patients who were hospitalized for chronic decompensated heart failure and monitored by the Palliative Care Center and Cardiology Clinic during a one-time hospitalization.
METHODS: A two-center retrospective study was performed. A total of 92 patients were included in this study. Thirty-eight out of the 92 were inpatients with chronic decompensated heart failure, and were monitored in the Palliative Care Center, and the other 54 were dealing with chronic decompensated heart failure and were treated at the Cardiology Clinic.
RESULTS: At the end of the day, 42.10% of the patients hospitalized in the Palliative Care Center and 37.03% of the patients hospitalized in the Cardiology Clinic were women. The mean age of the patients hospitalized in the Palliative Care Center was 76.71 ± 11.34 years; the mean age of the patients hospitalized in the Cardiology Clinic was 74.09 ± 11.16 years. There was no statistical difference between the two groups.
The duration of hospitalization for patients in the Palliative Care Center was longer than patients in the Cardiology Clinic.
The cost to the patient was greater in the palliative care center in terms of the average cost of treatment per patient, average cost of hospitality management and average total cost per patient, which was statistically important (p <0.05). The mortality rate that was observed during hospitalization was lower in the Cardiology Clinic by a statistically important margin (p <0.05).
DISCUSSION AND CONCLUSION: The cost of treatment, the cost of hospitality and the total cost of hospitalization for chronic decompensated heart failure patients were higher in the Palliative Care Center than in the Cardiology Clinic. However, it was observed that the rate of mortalityand higer co-morbidities in the Palliative Care Center was higher than the Cardiology Clinic.
Manuscript Language: English